Bowl filled with healthy vegetables.

Erectile Dysfunction and Diabetes: A Closer Look at the Connection

Updated 2020

Diabetes mellitus is a disease in which the body cannot properly process glucose, the primary energy source for the body’s cells. There are two primary types of diabetes: type 1 and type 2. Both can cause ED. However, you don’t have to allow diabetes to wreak havoc on your love life. There’s plenty you can do to help preserve your sexual function. 

Here’s what you need to know about diabetes and erectile dysfunction. ­

What’s the Connection Between Diabetes and ED?

ED and diabetes often go hand-in-hand. Research shows that men with diabetes are up to three times more likely to experience ED than men who don’t have the disease. For those who do develop erection problems, the onset tends to come 10 to 15 years earlier than in nondiabetics.

A higher likelihood of ED in people with diabetes is well-documented. The uncontrolled blood sugar levels caused by diabetes can lead to damaged nerves and blood vessels. Nerve damage affects a man’s sexual arousal and can cause erection problems. Blood vessel damage can reduce blood flow to the penis and also contributes to ED symptoms.

Diabetes can create a perfect storm of conditions that leads to ED in 35 to 75 percent of diabetic men and as high as 81 percent in men with type 2. These “storm conditions” can include:

  • Vasculopathy, a decrease in blood flow — in the case of diabetes, to the penis and extremities.
  • Dysfunction of the endothelium, the lining of the blood vessels. This condition decreases the body’s ability to produce nitric oxide, impeding its ability to produce an erection.
  • Sensory neuropathy — a loss of sensation that can include the genital area.
  • Hypogonadism (low testosterone).
  • Depression, which can lead to decreased sex drive and reduced response to arousal.

What’s more, ED is only one way uncontrolled diabetes can affect the male reproductive system. Diabetes is also associated with:

These complications are common to both type 1 and type 2 diabetes.

Inserting a test strip into a diabetes glucose monitor.

What Is the Difference Between Type 1 and Type 2 Diabetes?

People with type 1 diabetes (formerly known as insulin-requiring diabetes mellitus) don’t create enough insulin due to a malfunctioning pancreas. Type 1 is rare among adults, affecting only 5% of diabetic Americans. Studies show that 37 percent of people with type 1 diabetes have ED.

In type 2 diabetes, the body produces insulin but can’t use it properly. Most adults — over 66 percent — have type 2. Younger people, however, are more likely to have type 1.

Does It Affect All Ages?

Not necessarily. Young people are not immune to diabetes or the ED that can result. Type 1 usually comes on at a younger age than type 2 and is the type most commonly found in children and adolescents.

The risk for type 2 diabetes increases with age, but the numbers are rising for both forms of diabetes in young adulthood.

One study found that 26% of men under 40 have erectile dysfunction, and for half of those, ED symptoms are severe.

Young people who are overweight or have a family history of diabetes are most at risk. People of Hispanic, Asian, African American, or Native American descent are also more likely to have diabetes at a younger age.

The Truth About Prediabetes Screening

Younger men and older men alike can reduce their risk for diabetes by being on the lookout for prediabetes. The American Diabetic Association (ADA) introduced the term prediabetes in 2009. Ten years later, the idea is still somewhat controversial, but its guidelines are useful for identifying men at high risk for diabetes.

Prediabetes screening serves as an early warning so people can make lifestyle changes to delay, or even prevent, ED onset. It’s particularly useful for young men. Diabetes in this age group is increasing, particularly in overweight people, and early changes can dramatically decrease the chances of developing diabetes and ED later in life.

Taking a blood sample for a diabetic test.

How to Control Your ED Risk

So, yes, diabetes can wreak havoc on your love life. But it doesn’t have to. There are things you can do to prevent or postpone the development of ED, even if you have diabetes. The following actions can put your risk of diabetes-induced ED in your control.

  • Prioritize routine diabetic care. Men with diabetes must aggressively manage their disease. Keep regular medical appointments and lab checks. Check your blood sugar levels religiously, and do what it takes to get back to acceptable levels when they get too high.
  • Be aware of potential diabetes complicationsPeople with ED are at increased risk for heart disease, kidney disease, stroke, high blood pressure, eye damage, and severe problems with the feet. Again, you must see your doctor regularly. Monitoring for these conditions is a routine part of diabetic medical care. But if you experience new symptoms of any of these health issues, don’t wait for your next appointment — call your provider right away.
  • Eat a healthy diet. A healthy diet is essential to good sexual health, particularly if you are overweight. Following a diet that helps control the disease will also decrease your risk of ED as well, no matter your weight.Two excellent diet choices for diabetics are the Mediterranean and DASH diets. Studies have found that people with diabetes who follow a healthy diet have fewer problems with ED than those who eat a typical Western diet. If you have prediabetes, watch your sugar intake. An excess of sugar in the diet can cause ED even in men without diabetes.
  • Get plenty of exercise. In one study, men with higher levels of physical activity were 10% less likely to have ED as compared to those with lower levels. A word of warning here: If you’ve been sedentary until now, talk to your doctor before beginning an aggressive exercise program. It’s best to start slow and increase your activity gradually.
  • Maintain a healthy weight. While the connection between obesity and ED is not entirely understood, we know that excess weight can impede blood flow to the penis.If you have a high body mass index (BMI), weight loss may be the single most important thing you can do to protect against worsening diabetes and ED. (You can calculate your BMI here in just a few seconds.) A BMI of 25-29 would put you in the overweight category, and 30 or higher is considered obese.
  • Talk to your doctor about a weight-loss boost. If you’re on a healthy diet and find you’re having trouble losing or maintaining weight, ask your provider about Xenical, a weight loss aid that many doctors prescribe for people with diabetes who need a little help with their weight-loss efforts.
  • Don’t smoke. If you do smoke, quit. Nicotine constricts blood vessels, which interferes with blood flow to the penis and increases ED risk. Smoking also damages the inside walls of blood vessels, inhibiting blood flow and thus, erections.
  • Get enough sleep. Adequate sleep is essential for sexual health. Poor sleep is associated with poor health in general and with erectile dysfunction specifically. Aim for 7 to 9 hours of sleep per night to optimize your sexual health.
  • Be attentive to other medical conditions. Follow up with appointments and labs as recommended by your provider. Keep a close eye on your blood pressure; high blood pressure can worsen diabetes and ED symptoms. Follow your doctor’s orders regarding any other medical conditions you may have.
  • Manage stress.
    Stress can morph into performance anxiety. Consider learning a few relaxation techniques.
  • Limit alcohol. While moderate alcohol use tends to boost blood sugar levels, excess alcohol intake can cause blood sugar levels to plummet, creating a potentially dangerous situation. On top of that, too much alcohol can make it difficult for even nondiabetics to achieve an erection. It makes sense to minimize alcohol use and to monitor its effects on your blood sugar levels.
  • Consider an ED medication. If all the steps you’ve taken to prevent erectile dysfunction should fail, there’s still hope. Lifestyle medications such as Viagra, Levitra, and Cialis help most men with ED symptoms enjoy happy and fulfilling sex lives.As a bonus, recent research suggests that these drugs may even help to enhance insulin sensitivity in men with diabetes along with blood flow in the extremities (a common problem for diabetics). Talk to your doctor about whether a PDE5 inhibitor may help manage your diabetes as well as your ED symptoms.

Smiling couple outside.

Can Diabetes-induced Erectile Dysfunction Be Reversed?

It’s possible! Many men who make lifestyle changes like those listed above can and do reverse their ED. For some men, however, there can be psychological issues underlying their ED symptoms. In some cases, men find that the confidence boost an ED drug provides is enough to solve the problem. Others need to combine lifestyle changes with counseling or sex therapy to get results.

Even when reversal or cure is not possible, an ED med can help most men.

Which ED Medication is Best for Me?

All PDE5 inhibitors have been evaluated for ED in diabetic patients and are safe and effective. However, there are some differences among them:

  • Sildenafil (the generic form of Viagra) has the least favorable side effect profile and is associated with temporary visual changes (though serious side effects among all PDE5 inhibitors are rare).
  • Vardenafil (Levitra) can cause QT prolongation.
  • Tadalafil (Cialis) can cause lower back pain but has the longest half-life (meaning its effects last longer).
  • Oral dissolving tablets avanafil (Stendra) and vardenafil ODT (Staxyn) work faster than the other ED meds.
  • Some men who have found that Viagra doesn’t work for them have found success with Levitra.
  • Cialis is also available in a once-daily form, a great option if you have a regular, active sex life and would like to be ready at any time. The research shows that daily Cialis is a safe and effective alternative to on-demand treatment.

With all of these meds, the first-time response is approximately 60 to 70 percent, with no significant differences among them. The research does not find one medication to be “the best.” Treatment success rates are 89 percent overall.

Talk to your doctor about which might be best for your situation.

IMPORTANT NOTE: MEN WHO ARE TAKING NITRATES FOR HEART DISEASE SHOULD NOT TAKE PDE5 INHIBITORS (ED MEDICATIONS)! PDE5 inhibitors can lower your blood pressure. Because nitrates lower blood pressure by design, taking both together can lower pressure to dangerous levels. If you’re not sure which heart or blood pressure medications you are taking, check with your doctor before trying any ED medication.

Smiling couple cuddling.


While there is currently no cure for diabetes, you may not have to live with the ED that can come with it. If you’re serious about taking control of your erectile dysfunction, you have many options available to you. With lifestyle changes and good self-care, you may be able to kick ED out of bed — for good!


If you’re interested in trying a lifestyle medication such as Viagra, Cialis, or Levitra, or one of our newer ED products, Staxyn or Stendra, visit our erectile dysfunction page. offers a complimentary consultation with a doctor licensed to practice in all 50 states, so getting a prescription is easy. We will then ship your product to you quickly and discreetly, and the shipping fee is on us.

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